Avian Flu — the Most Serious Known Health Threat Facing the World
Threat of Bird Flu Pandemic Dominates World Health AssemblyMay 17, 2005
ENS
GENEVA, Switzerland, - Avian influenza is the most serious known health threat the world is facing, World Health Organization Director-General Lee Jong-wook told opening of the 58th World Health Assembly on Monday. Comparing the possibility to the Spanish flu pandemic in 1918, which killed between 20 and 50 million people, Lee said, "The timing cannot be predicted, but rapid international spread is certain once the pandemic virus appears. This is a grave danger for all people in all countries."
"By good fortune we have had time - and still have time - to prepare for the next global pandemic, because the conditions for it have appeared before the outbreak itself," said Lee. We must do everything in our power to maximize that preparedness. When this event occurs, our response has got to be immediate, comprehensive and effective."
The most inclusive recent expression of the will of governments around the world is the Millennium Development Goals, and they place health at their center, Lee said. "Yet the translation of those goals into reality is still very far from completion, and progress towards them is not reassuring."
The eight Millenium Development Goals pledge that by 2015 governments of the world will reduce by half the proportion of people living on less than a dollar a day, and reduce by half the proportion of people who suffer from hunger, and reduce by half the proportion of people without sustainable access to safe drinking water. They pledge to reduce by two thirds the mortality rate among children under five, and reduce by three quarters the maternal mortality ratio.
"Unless we succeed in bringing about the major changes we are working for in the very near future, the targets for reducing child mortality will not be achieved by 2015," Lee said. "This is a simple clear fact."
Other Millenium Development Goals are to halt and begin to reverse the spread of HIV/AIDS, malaria and other major diseases, but Lee says the world is not making enough progress towards these goals.
"Although the coverage rates for some health interventions have risen as planned," the WHO chief said. "We have not yet seen the necessary improvement in health indicators," "In some areas death rates have actually risen as a result of extreme poverty and epidemics. The technical and practical know-how exists for achieving what is necessary for global health but we have not yet found the ways to apply it on a large enough scale."
Guest speakers at the World Health Assembly opening were President of the Maldives Maumoon Abdul Gayoom, Bill Gates, co-founder of the Bill and Melinda Gates Foundation, and Ann Veneman of the United States, the new executive director of UNICEF.
"An integrated approach to child survival designed to deliver a package of lifesaving health services for children in hard to reach communities has shown remarkable results," Veneman said Monday at the World Health Assembly.
The program, called Accelerated Child Survival and Development (ACSD), was initiated in some 100 districts within 11 countries in West Africa beginning in 2002.
After three years of increasing coverage in basic health interventions, UNICEF estimates that child deaths will have dropped by an average of 20 percent across the 16 districts where the program was fully implemented, and by 10 percent where it was partially applied.
“The early results of this initiative are remarkable,” said Veneman. “They have exceeded expectations, and shown us just what can be achieved over a short period of time through sound science using an integrated approach.”
Funded by the Canadian government and initiated by UNICEF, the ACSD model utilizes the expertise and partnership of multiple players on the ground, including governments and health ministries, WHO, the World Bank, numerous non-governmental groups, local community leaders, and others. The model relies on the involvement of everyone who has a role in women’s and children’s health.
Microsoft Chairman Bill Gates, too, expressed concern about the situation of people in developing countries who fall ill. "In my view – and there is no diplomatic way to put this: The world is failing billions of people. Rich governments are not fighting some of the world’s most deadly diseases because rich countries don’t have them. The private sector is not developing vaccines and medicines for these diseases, because developing countries can’t buy them. And many developing countries are not doing nearly enough to improve the health of their own people."
Gates was invited to speak because the Bill and Melinda Gates Foundation has donated hundreds of millions of dollars to solving some of the toughest health problems in the world today. Monday, he more than doubled that grant from $200 million to $450 million.
"Let’s be frank about this. If these epidemics were raging in the developed world, people with resources would see the suffering and insist that we stop it. But sometimes it seems that the rich world can’t even see the developing world," Gates said. We rarely make eye contact with the people who are suffering – so we act sometimes as if the people don’t exist and the suffering isn’t happening."
"All these factors together have created a tragic inequity between the health of the people in the developed world and the health of those in the rest of the world. I am here today to talk about how the world, working together, can dramatically reduce this inequity," Gates said.
"I am optimistic, Gates said. "I’m convinced that we will see more groundbreaking scientific advances for health in the developing world in the next 10 years than we have seen in the last 50."
"We are on the verge of taking historic steps to reduce diseases in the developing world," he said. "Never before have we had anything close to the tools we have today to both spread awareness of the problems and discover and deliver solutions."
Maldives President Gayoom invited the Assembly to imagine a day when "all of a sudden, and without warning the sea swells to some four meters (13 feet), and crashes through the whole island. Within a matter of minutes, the waters recede as the tsunami rips through the Indian Ocean, In its wake, loved ones go missing, never ever to be seen alive again, the whole island is turned into rubble, and the entire community is left in shock."
Gayoom expressed his gratitude to the international community for its swift response, but said he was concerned that donors have been slow to provide assistance for the cleanup operation and for "the important task of reconstructing the damaged water and sewerage infrastructure."
After the opening plenary U.S. Secretary of Health and Human Services Mike Leavitt convened a ministerial meeting on avian influenza with the health ministers and heads of delegation from both affected countries and donor countries.
"Many of us are particularly worried about H5N1 avian influenza virus, and we’re right to worry," Leavitt told the meeting. "It has infected at least 89 human beings and killed more than half. There is a chance that this virus could cause the next pandemic."
Leavitt said he is briefed daily on the status of bird flu and that President George W. Bush "understands the gravity of our situation."
"If a flu pandemic starts, public health officials need to be able to react right away across borders - regardless of the relationships among governments - to bring treatment to the victims and protect others from infection," Leavitt said.
"To maximize our preparation, we need to cooperate and communicate, regularly and without surprises," the U.S. health official said. "We need to identify the short- and longer-term barriers to sustainable action on avian influenza. Developed countries need to know where affected countries need the most assistance to address the control and treatment of this virus. We want to work with you."
Leavitt explained that the U.S. National Institutes of Health have this year initiated clinical trials of a vaccine specifically designed against the H5N1 strain that is circulating in Asia. "We have also gone ahead and produced two million doses of this vaccine in bulk," he said.
The U.S. delegation hosts a technical meeting on avian flu today co-chaired by the Kingdom of Thailand and the WHO Secretariat. WHO will also have a technical briefing on avian influenza on Wednesday.
"Pandemic flu is an urgent health challenge, and preparedness is the best defense," Leavitt said. "Transparency, strong surveillance, and communication are essential components of our response to this threat."
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